SOFT-PASS ECHOTIP EMBRYO TRANSFER CATHETER SET K-J-SPPE-681710-ET

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2018-01-18 for SOFT-PASS ECHOTIP EMBRYO TRANSFER CATHETER SET K-J-SPPE-681710-ET manufactured by Cook Inc.

Event Text Entries

[97709881] (b)(4). The event is currently under investigation. A follow up report will be submitted upon receipt of additional information or completion of the investigation.
Patient Sequence No: 1, Text Type: N, H10


[97709882] The customer reported that one normal female blastocyst was thawed in preparation for the embryo transfer procedure. Prior to the embryo transfer procedure a trial transfer was performed using the cook soft-pass echotip embryo transfer catheter set. During the trial transfer the metal of the echo-tip soft-pass embryo transfer catheter was noted to be missing and the transabdominal ultrasound showed a small echogenic area within the lower uterine segment consistent with the metal of the echo-tip catheter. The embryo transfer procedure was cancelled and on the following day a hysteroscopic removal of the metal was successfully done. No further information is available at this time regarding the patient or procedure.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1820334-2018-00016
MDR Report Key7203571
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2018-01-18
Date of Report2018-04-20
Date of Event2017-12-18
Date Mfgr Received2018-04-19
Device Manufacturer Date2017-09-06
Date Added to Maude2018-01-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. LARRY POOL
Manufacturer Street750 DANIELS WAY
Manufacturer CityBLOOMINGTON IN 47404
Manufacturer CountryUS
Manufacturer Postal47404
Manufacturer Phone8123392235
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSOFT-PASS ECHOTIP EMBRYO TRANSFER CATHETER SET
Generic NameMQF CATHETER, ASSISTED REPRODUCTION
Product CodeMQF
Date Received2018-01-18
Catalog NumberK-J-SPPE-681710-ET
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCOOK INC
Manufacturer Address750 DANIELS WAY BLOOMINGTON IN 47404 US 47404


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-01-18

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